Improved features of medical devices. Implants that may include self-expanding portions and portions that are expandable with an inflatable body. A portion expandable with an inflatable body may dock with a portion that is self-expanding. A portion expandable with an inflatable body may be coupled to a portion that is self-expanding. Delivery apparatuses for deployment of both a self-expanding portion and a portion expandable with an inflatable body may be disclosed.
A prosthetic valve includes a radially expandable and compressible frame, a leaflet assembly comprising a plurality of leaflets coupled to the frame, and an outer skirt positioned around an outer surface of the frame. The outer skirt includes a tissue layer and a non-tissue layer. The tissue layer has a fibrous side and a smooth side. The non-tissue layer is coupled to the smooth side of the tissue layer. The outer skirt is positioned so that the fibrous side of the tissue layer faces away from the frame and the non-tissue layer faces towards the frame.
Prosthetic heart valves are disclosed. As an example, a prosthetic heart valve comprises a frame having an inflow end and an outflow end that is expandable between a radially compressed configuration and a radially expanded configuration; and a skirt disposed around an outer surface of the frame and having an inflow portion and an outflow portion, the skirt comprising a first plurality of axially extending fibers disposed in the inflow portion and a second plurality of axially extending fibers disposed in the outflow portion, wherein each of the first plurality of fibers include two fixed ends, wherein at least one of the second plurality of fibers includes a free end and a fixed end.
Various implementations include an expandable sheath system (300) including a radially expandable sheath (208) including a restraining member (385) limiting expansion of the sheath and methods of making the same.
A delivery apparatus for a prosthetic heart valve can comprise a shaft having a proximal end portion and a distal end portion, and an inflatable balloon mounted on the distal end portion of the shaft. The inflatable balloon can comprise a first conical portion, a second conical portion axially disposed relative to the first conical portion, and a central longitudinal axis extending between the first conical portion and the second conical portion. The first conical portion can have a first axial length and the second conical portion can have a second axial length that is different than the first axial length. The first conical portion has a first slope relative to the central longitudinal axis and the second conical portion has a second slope relative to the central longitudinal axis that is different than the first slope.
A61F 2/958 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes ballons gonflables pour insérer les stents ou les endoprothèses déployables couvertes
6.
LUMEN LINER SEALS AND ASSOCIATED METHODS FOR PROSTHETIC IMPLANT DELIVERY APPARATUSES
Steerable delivery apparatuses with lumen liner seals and associated methods. In an example, a steerable delivery apparatus includes a flexible tube, a control wire lumen liner at least partially defining a control wire lumen, a control wire disposed within the control wire lumen, a coil sleeve disposed around the control wire, a coil stopper abutting the coil sleeve, and a lumen liner seal that forms an at least substantially fluid-tight seal between the control wire lumen liner and the coil stopper. In another example, a method includes positioning a control wire lumen liner proximate to a coil stopper, positioning a lumen liner seal over a portion of each of the control wire lumen liner and the coil stopper, and transitioning the lumen liner seal to a contracted configuration to form an at least substantially fluid-tight seal between the control wire lumen liner and the coil stopper.
A valve repair device and valve repair systems including a delivery device and a valve repair device for repairing a native valve of a subject. The valve repair device and/or the delivery device having one or more force measurement devices for detecting a force applied to the native valve of a subject due to the connection between the valve repair device and the native valve.
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
Systems and methods for synthesis of covers for valvular prosthetics are described. Generally, covers can be synthesized via depositing, submersion, and/or printing. Covers can be synthesized directly onto a valvular frame or synthesized on a temporary substrate and transferred onto the valvular frame. Covers can be synthesized having one or more layers. The covers and the various layers can be synthesized or treated to obtain beneficial properties.
Described herein are shunt devices configured to achieve a targeted reduction in peak systolic pressure by percutaneous ly shunting from the superior vena cava to the right pulmonary artery. The shunt devices include a check valve with a cracking pressure to preserve a minimal transpulmonary pressure. Also described herein are flow diversion devices placed between pulmonary circulation vessels and venous vessels. The disclosed flow diversion devices are physiologically responsive through an adjustable orifice that can be adjusted after initial implantation through a non-invasive or minimally invasive procedure. Disclosed herein are flow control systems that are configured to reduce recruitment of blood from the splanchnic system. The flow control systems include a variable orifice constrictor (e.g., a covered stent) and a controller that delivers energy to the constrictor to reduce the cross-sectional area of the lumen through the variable orifice constrictor.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61F 2/82 - Dispositifs maintenant le passage ou évitant l’affaissement de structures tubulaires du corps, p.ex. stents
A medical access system can comprise an inner needle assembly including an inner needle shaft configured to be slidably disposed at least partially within a delivery lumen of an outer needle assembly, the inner needle shaft comprising a narrower distal portion and a wider portion proximal of the narrower distal portion, and a transition segment between the narrower distal portion and the wider portion. A first delivery lumen within the inner needle shaft can extend from a proximal end of the inner needle shaft to a distal end opening at a distal end of the narrower distal portion, and a second delivery lumen within the inner needle shaft can extend from the proximal end to a distal opening associated with the transition segment.
Systems and methods arc for evaluating preload responsiveness utilizing hemodynamic data that is derived from a continuous blood pressure or blood flow sensor representative of right-side measurements from the heart. Hemodynamic data features can be derived from a blood pressure or blood flow waveform and utilized to determine hemodynamic parameters to guide fluid resuscitation treatment and/or maintain the health and wellbeing of a patient that, such as a patient under monitoring during a surgery. In one example, beat-to-beat right-side stroke volume variation (SVV) is determined as a function of the standard deviation of the blood pressure waveform over a plurality of cardiac cycles.
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
A system for monitoring right ventricular systolic dysfunction includes a hemodynamic sensor that produces a hemodynamic sensor signal representative of a right ventricular pressure waveform of the patient, a display, one or more processors, and computer-readable memory. The computer-readable memory is encoded with instructions that, when executed by the one or more processors, cause the system to receive the hemodynamic sensor signal representative of the right ventricular pressure waveform of the patient, extract right ventricular peak systolic pressure and right ventricular end diastolic pressure from the right ventricular pressure waveform of the patient, determine a ratio of right ventricular peak systolic pressure over right ventricular end diastolic pressure, and output the ratio of right ventricular peak systolic pressure over right ventricular end diastolic pressure to the display for monitoring the presence of right ventricular systolic dysfunction based on the ratio of peak systolic pressure over end diastolic pressure.
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
13.
TRANSCATHETER HEART VALVES WITH IMPROVED BLOOD FLOW
A prosthetic heart valve includes three prosthetic valve leaflets coupled together at three commissure regions to form a central flow path. A collapsible and expandable valve frame is provided for supporting the prosthetic valve leaflets. The valve frame includes three cantilevered support arms for supporting the three commissure regions and gaps are provided between the three cantilevered support arms for improving leaflet coaptation and reducing thrombus formation. The valve frame is positioned within an outer sealing frame and the sealing frame anchors to surrounding heart tissue. The prosthetic heart valve is adapted to be delivered using a minimally invasive transcatheter procedure. The prosthetic heart valve is preferably used for replacing a native mitral or tricuspid valve.
Devices and methods for replacing a malformed or defective heart are provided. The devices can include a flexible hollow structure sized for deployment within the right side of a human heart. The hollow structure preferably includes an inlet, an outlet, and a one-way prosthetic valve. The hollow structure allows blood to pass therethrough and effectively replaces the function of the right side of the heart. The hollow structure is preferably flexible for allowing natural beating of the heart after deployment in the body. The device is particularly well-suited for treating a congenital malformation of the tricuspid valve known as Ebstein's anomaly.
A device may include a frame including an inflow end and an outflow end. The frame defines a lumen between the inflow end and the outflow end. A device may include a first expandable member coupled to at least one portion of an internal surface of the frame and including a first inflation port. The first expandable member defines a first volume configured to receive an inflation fluid therein through the first inflation port. The first expandable member is configured to be reversibly inflatable to a first plurality of inflation states to partially or fully occlude the lumen. The devices described herein may be used to treatment a subject having one or both of: congestive heart failure or chronic kidney disease.
A61M 60/135 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables par, dans, à l’intérieur, en ligne, se ramifiant dans ou autour d’un vaisseau sanguin à l’intérieur d’un vaisseau sanguin, p.ex. par greffe
A61M 60/295 - Pompes à ballon pour assistance circulatoire
A61M 60/30 - Leurs finalités médicales étant autres que l’amélioration du débit cardiaque
A61M 60/531 - Régulation par des données du patient en temps réel par des données de tension artérielle, p.ex. provenant de capteurs de tension
A61M 60/843 - Aspects du ballon, p.ex. formes ou matériaux
A61M 60/861 - Connexions ou ancrages pour connecter ou ancrer les pompes ou dispositifs de pompage à des parties du corps du patient
A61M 60/892 - Vannes actives, c. à d. actionnées par une force externe
A dilator (400) including: a dilator shaft (410); a knob (430) coupled to a proximal end of the dilator shaft; a dilator hub (450) rotatably coupled to the knob; and a pin coupling the dilator hub with the dilator shaft and preventing rotational movement therebetween, wherein rotational movement of the knob results in a corresponding axial movement of the dilator shaft in a direction along a longitudinal axis of the dilator.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
17.
IMPEDANCE-BASED TISSUE CAPTURE CONFIRMATION SYSTEM FOR A SHUNT DEVICE
A device for determining tissue capture of a shunt device includes a delivery catheter and a shunt device disposed on the delivery catheter. The shunt device is configured to be inserted into a puncture in a tissue wall and includes a central flow tube extending from a first axial end to a second axial end, a first distal arm attached to the first axial end of the central flow tube, and a first proximal arm attached to the second axial end of the central flow tube. The first distal arm and the first proximal arm configured to capture the tissue wall therebetween, and the delivery catheter includes a first conductive wire and a second conductive wire. The first conductive wire is electrically connected to the shunt device and the second conductive wire is separated from the shunt device.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
18.
SYSTEMS FOR EPICARDIAL TISSUE DISTENSION SOLUTIONS
Systems and methods for improving epicardial tissue distension are described. Drug delivery elements can deliver drugs that can dissolve epicardial fat and/or weaken pericardial connective tissue. Distension systems can provide mechanical distension of the pericardium. The drug delivery and the distension systems can be combined to improve epicardial tissue distension.
A clip may be configured to close the portion of the heart, to reduce blood flow therethrough as well as passage of clots or other undesired materials. The clip may be configured to close the left atrial appendage (LAA). The closure of the LAA may reduce the possibility of stroke or other maladies stemming from fluid flow with the LAA. Delivery systems may comprise expansion apparatuses for a left atrial appendage clip. The expansion apparatuses may include retention mechanisms for retaining the clip.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A cross-plane seal having a distal end and a proximal end includes a disc at the distal end. The disc includes a distal face at a distal side, a proximal face at a proximal side, a plurality of cut outs in the distal face forming a raised X-shape on the distal face, a first slit having a partial through-cut into the distal face and aligned with a first leg of the raised X-shape, the through-cut extending more than halfway through the thickness of the disc, a second slit having a partial through-cut into the proximal face and aligned with a second leg of the raised X-shape, the through-cut extending more than halfway through the thickness of the disc, and an intersection formed by the first slit and the second slit. An annular portion is connected to and extends proximally away from the disc.
A clip may be configured to close the portion of the heart, to reduce blood flow therethrough as well as passage of clots or other undesired materials. The clip may be configured to close the left atrial appendage (LAA). The closure of the LAA may reduce the possibility of stroke or other maladies stemming from fluid flow with the LAA.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
22.
SYSTEMS, APPARATUSES, AND METHODS FOR CLIPS FOR LEFT ATRIAL APPENDAGE CLOSURE
A clip may be configured to close the portion of the heart, to reduce blood flow therethrough as well as passage of clots or other undesired materials. The clip may be configured to close the left atrial appendage (LAA). The closure of the LAA may reduce the possibility of stroke or other maladies stemming from fluid flow with the LAA.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
Systems, devices, and methods for the automated tying of knots as part of a suturing process for a target device, such as a prosthetic heart valve. The automated knot tying systems automatically tie two free ends of thread or sutures on a heart valve into a knot. The automated knot tying systems include fixtures whose coordinated movement result in tying one or more knots in sutures. The automated knot tying systems can be used with wet or dry tissue on a prosthetic heart valve. The automated knot tying systems can be configured to tie a variety of knots including overhand knots, double overhand knots, square knots, double square knots, etc.
The present disclosure relates to devices designed to aid in accurate positioning and deployment of prosthetic valves inside a native annulus. In an example, a delivery assembly comprises a prosthetic valve comprising a frame movable between radially compressed and expanded configurations, and a delivery apparatus. The delivery apparatus includes an outer delivery shaft, and at least one elongated positioning member extending through, and axially movable relative to, the outer delivery shaft. The elongated positioning member is configured to position a distal end thereof radially outward to the prosthetic valve and axially distal to an outflow end of the frame. In some examples, the delivery apparatus can further include at least one sensor attached to the elongated positioning member.
The present disclosure relates prosthetic valves and assemblies that include an outer skirt releasably coupled to the frame or to another skirt of the prosthetic valve. In an example, a prosthetic valve assembly includes a prosthetic valve comprising an annular frame and a first skirt attached to the frame, and a second skirt disposed radially outward to the first skirt and releasable coupled to the first skirt via at least one retaining suture attached to the frame and extending through inflow and outflow loops of the first and second skirts. The second skirt is configured to be released from the first skirt upon withdrawal of the at least one retaining suture from the inflow and outflow7 loops of both skirts.
Systems and methods for damping pressure pulsations are provided. A damping system can comprise a system of expansion chambers with indirect ports within the chambers to reduce pressure pulsations. A release valve can be provided to reduce pressure pulsations as well.
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/0225 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres la pression étant commandée par des signaux électriques, p.ex. dérivés des bruits de Korotkoff
A61B 5/0235 - Valves spécialement adaptées à cet effet
27.
SYSTEMS AND DEVICES FOR BLOOD PRESSURE MEASUREMENT
Systems and devices for performing hemodynamic measurements are provided. A blood pressure cuff can have a fixed tubular shape. The blood pressure cuff can include an inflatable bladder and a housing with an inflation chamber formed in between the inflatable bladder and housing. The blood pressure cuff is configured to fit onto an extremity of an individual. The inflatable bladder can include angled segments to help secure the blood pressure cuff to the extremity.
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/022 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres
28.
HEART VALVE TREATMENT DEVICES AND DELIVERY DEVICES THEREFOR
A valve treatment device having a coaptation element, a first anchor assembly configured to grasp a first leaflet of a native heart valve, and a second anchor assembly configured to grasp a second leaflet of the native heart valve. The first anchor assembly is connected to a first side of the coaptation element, the second anchor assembly is connected to a second side of the coaptation element, and a bioabsorbable central portion between the first anchor assembly and the second anchor assembly.
Balloon catheter with an inflatable balloon (218) having a protrusion (292) disposed on the outer surface of the balloon. The balloon can be configured to first rupture at the protrusion when the balloon is overinflated. Further a mold (1100) for a catheter balloon comprising a first mold portion (1510), a second mold portion (1540), and a channel (1528a, 1528b) formed on the first mold portion. The first mold portion can comprise a first inner surface (1512) and a first outer surface (1514). The second mold portion can comprise a second inner surface (1542) and a second outer surface (1544), wherein the first mold portion and the second mold portion form a parting line (1560) extending in an axial direction of the mold when the first mold portion and the second mold portion are coupled together. The mold can be configured to form a balloon comprising features that help facilitate the retrieval and removal of the balloon from a patient's vasculature. Further a method of forming such a balloon catheter.
B29C 49/00 - Moulage par soufflage, c. à d. en soufflant une préforme ou une paraison dans un moule pour obtenir la forme désirée; Appareils à cet effet
A prosthetic heart valves including an annular frame and one or more detachable outer skirts and methods associated therewith are disclosed. The frame includes a plurality of interconnected struts and one or more outer skirts releasably attached to an exterior surface of the frame. In some examples, an outer skirt is attached to the frame via at least one retaining suture formed by a plurality of stitches looped around a pull suture. Removal of the pull suture from the suture line enables the outer skirt and frame to separate as the stitches are pulled through openings in the outer skirt and remain attached to the frame. Removability of the outer skirt can facilitate improvements in implant and explant procedures of the prosthetic valves, such as, for example, valve- in-valve procedures.
Disclosed herein are prosthetic valves with outer skirts that include patterned threads extending over base layers thereof to provide PVL sealing functionality, and methods for forming such patterned outer skirts. As one example, a prosthetic valve can include an annular frame and an outer skirt disposed around the frame, wherein the outer skirt comprises a base layer, a multi-yarn thread comprising a plurality of multi-filament yarns, and a backing thread. The multi-yarn thread can be embroidered to the base layer and define outer portions extending over an outer surface of the base layer, while the backing layer extends over an inner surface of the base layer, and is wound over the multi-yarn thread at stitch points defined at ends of the outer portions.
A61F 2/00 - Filtres implantables dans les vaisseaux sanguins; Prothèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corps; Appareils pour les assujettir au corps; Dispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p.ex. stents
32.
SENSOR ASSEMBLY WITH SPECTROPHOTOMETRIC SENSOR PORTION AND ELECTRODE SENSOR PORTION
A physiological sensor assembly is provided that includes a NIRS sensor portion, an electrode sensor portion, and a SA connector. The NIRS sensor portion has a light source, a light detector, and a flexible NS connector tail. The electrode sensor portion has first and second segments and a plurality of electrodes. The first segment has an electrode and a flexible FES connector tail. The second segment has an electrode and a flexible SES connector tail. The SA connector is in communication with the NIRS sensor portion, the electrode sensor portion first and second segments. The flexible NS connector tail, the flexible FES connector tail, and the flexible SES connector tail each extend outwardly from the SA connector independently of one another. The NIRS sensor portion, the electrode sensor portion first segment, and the electrode sensor portion second segment are independently positionable relative to one another.
A61B 5/1455 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang en utilisant des capteurs optiques, p.ex. des oxymètres à photométrie spectrale
A61B 5/291 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci Électrodes bioélectriques à cet effet spécialement adaptées à des utilisations particulières pour l’électroencéphalographie [EEG]
A61B 5/369 - Modalités, c. à d. méthodes diagnostiques spécifiques Électroencéphalographie [EEG]
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
Various examples include a sheath system (300) and corresponding dilator (350). The system includes a radially expandable sheath having an inner layer and a tubular strain relief layer (26), and a dilator sized and configured to be received within the lumen of the sheath. The dilator includes an expansion element (365) for expanding the central lumen of the sheath.
A docking device for securing a prosthetic valve at a native valve includes a coil having a plurality of helical turns when deployed at the native valve and a clasp member attached to the coil. The clasp member includes a first end portion and a second end portion The second end portion is fixed relative to the coil and the first end portion is movable between an open position and a closed position. When in the closed position, the first end portion of the clasp member is adjacent to the coil so that the clasp member extends substantially parallel to a segment of the coil. When in the open position, the first end portion is spaced away from the coil so that the clasp member extends angularly relative to the segment of the coil.
A system (500) for use at an anatomical site of a subject includes an implant (518) that comprises a porous matrix (472) and a composition (too) that is held in association with the matrix. The composition comprises a mixture that includes a first component (102) and a second component (104) that is encapsulated in capsules (106) in a manner that prevents its interaction with the first component. The capsules are rupturable to expose the second component to the first component responsively to application of energy to the composition. Other embodiments are also described.
The devices and methods disclosed herein relate to a puncture device that includes a sharpened coil; a needle configured to extend from the distal end of the catheter through a central axis of the sharpened coil, wherein the sharpened coil anchors the catheter to the targeted tissue to facilitate puncturing of the targeted tissue with the needle. The needle comprises a dilation device that is configured to open the tissue and to create a conduit between both vessels. The sharpened coil is detachable from the catheter.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A balloon catheter can comprise a shaft and a balloon coupled to a distal end portion of the shaft. The balloon can comprise a main body having first and second end portions and a sleeve. The sleeve can comprise a first end portion extending partially over the first end portion of the balloon and a second end portion extending partially over an adjacent surface of the balloon catheter. The first end portion of the sleeve can comprise a first plurality of circumferentially spaced, axially extending fingers. The second end portion of the sleeve can comprise an intermediate portion and a second plurality of fingers extending in a direction opposite the first plurality of fingers.
Systems and methods for monitoring hemodynamic parameters are described. The systems and methods can combine hemodynamic parameters to yield enhanced parameters.
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 5/028 - Mesure du débit sanguin utilisant des marqueurs, p.ex. dilution de colorant par thermodilution
A61B 5/029 - Mesure du débit de sang à la sortie du cœur, p.ex. volume éjecté par minute
A folding device for an introducer sheath is disclosed herein. The folding device includes a housing including a plurality of jaws rotatably coupled to the housing, each of the plurality of jaws is rotatable within a corresponding channel extending through a side wall of the housing. Each of the plurality of jaws are rotatable between a first (retracted) position, where the plurality of jaws do not extend into a central opening of the housing, and a second (contracted) position where at least a portion of each of the plurality of jaws extends into the central opening of the housing in a configuration to fold and/or compress a portion of the sheath received within the central opening of the housing.
A shunt system includes a shunt configured to maintain a blood flow pathway between a first blood vessel and a second blood vessel and a deformable device configured to elastically deform in response to blood flow through the shunt.
A61M 60/135 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables par, dans, à l’intérieur, en ligne, se ramifiant dans ou autour d’un vaisseau sanguin à l’intérieur d’un vaisseau sanguin, p.ex. par greffe
A61M 60/152 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables par, dans, à l’intérieur, en ligne, se ramifiant dans ou autour d’un vaisseau sanguin se ramifiant sur un vaisseau sanguin et en en prélevant du sang
A61M 60/274 - Pompes pour le sang à déplacement positif comportant un élément de déplacement agissant directement sur le sang l’élément de déplacement étant souple, p.ex. membranes, diaphragmes ou vessies l’entrée et la sortie étant identiques, p.ex. pompes pour le sang à contre-pulsation para-aortique
A61M 60/295 - Pompes à ballon pour assistance circulatoire
A61M 60/837 - Aspects des éléments de déplacement souples, p.ex. formes ou matériaux
A61M 60/843 - Aspects du ballon, p.ex. formes ou matériaux
A61M 60/861 - Connexions ou ancrages pour connecter ou ancrer les pompes ou dispositifs de pompage à des parties du corps du patient
A61M 60/882 - Dispositifs mus par le patient, p.ex. dispositifs mus par muscle squelettique
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A system for determining placement of a catheter in a patient includes a hemodynamic sensor and a display. The hemodynamic sensor produces a signal representative of a right ventricular pressure waveform of the patient. The catheter is connected to the hemodynamic sensor. The system further includes one or more processors and computer-readable memory encoded with instructions that, when executed by the one or more processors, cause the system to receive the signal representative of the right ventricular pressure waveform and extract features from the right ventricular pressure waveform. The instructions further cause the system to compare the features to one or more value ranges of the features to determine that the catheter is correctly placed when values of the features are within the one or more value ranges or that the catheter is incorrectly placed, is not properly connected to the system, or signal quality issues are occurring.
A system for determining a hemodynamic condition of a patient includes a hemodynamic sensor and a display. The hemodynamic sensor produces a hemodynamic sensor signal representative of a right ventricular pressure waveform of the patient. The system further includes one or more processors and computer-readable memory encoded with instructions that, when executed by the one or more processors, cause the system to receive the hemodynamic sensor signal representative of the right ventricular pressure waveform of the patient. The instructions further cause the system to estimate a filtered cardiac output by filtering one or more cardiac output estimates using a Kalman filter algorithm and output the filtered cardiac output to the display. At least one of the one or more cardiac output estimates is determined using the right ventricular pressure waveform of the patient or features extracted from the right ventricular pressure waveform of the patient.
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A61B 5/02 - Mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin; Détermination combinée du pouls, du rythme cardiaque, de la pression sanguine; Evaluation d'un état cardio-vasculaire non prévue ailleurs, p.ex. utilisant la combinaison de techniques prévues dans le présent groupe et des techniques d'électrocardiographie; Sondes cardiaques pour mesurer la pression sanguine
43.
PROSTHETIC VALVE ASSEMBLIES WITH EXPANSION CONTROL RODS
The present disclosure relates to prosthetic valves that can be expanded to selected maximal diameters. In an example, a prosthetic valve assembly comprises a prosthetic valve having an annular frame, one or more expansion control rods disposed radially outward to the frame, and one or more flexible tension members extending circumferentially around the frame, and comprising one or more local loops wrapped around the corresponding expansion control rods. The flexible tension member is configured to radially expand to a first diameter when all local loops are wrapped around the corresponding expansion control rods, and expand to a second diameter greater than the first diameter, when one of the expansion control rod is retracted from the flexible tension member, thereby allowing the corresponding local loop to unravel.
Various implementations include an inflatable sheath for delivering a medical device, the sheath an inner layer (310) and an outer layer (320) defining a fluid chamber (330) therebetween that when inflated expands the sheath from an unexpanded configuration in which the central lumen (312) has a first diameter to an expanded configuration in which the central lumen has a second, larger, diameter.
A method of measuring arterial pressure includes receiving a first arterial volume setpoint, adjusting an air pressure of an air bladder to a first air pressure, receiving a first plethysmographic signal from a plethysmographic sensor, analyzing the first plethysmographic signal to determine a first waveform feature, generating a setpoint adjustment value based on the first waveform feature, and generating a second arterial volume setpoint. The first arterial volume setpoint is received by a processor and an air pressure of the air bladder is adjusted by a pressure controller operatively connected to the processor. The first plethysmographic signal is representative of a first arterial volume waveform and is received by the processor while the air pressure of the air bladder is at the first air pressure. The second arterial volume setpoint is generated by adjusting the first arterial volume setpoint based on the setpoint adjustment value.
A61B 5/0225 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres la pression étant commandée par des signaux électriques, p.ex. dérivés des bruits de Korotkoff
A61B 5/021 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
46.
SYSTEMS AND METHODS FOR CONTINUOUS CARDIAC OUTPUT MONITORING
Devices, systems, and methods provide measurements of continuous cardiac output (CCO). A pulmonary artery (PA) catheter — for example, a Swan-Ganz catheter — can be utilized to obtain multiple pressure measurements simultaneously from different locations within the circulatory system, such as in a pulmonary artery, right atrium, right ventricle, vena cava, etc. Continuous pressure measurements from multiple points can provide estimates of heart rate and stroke volume allowing computation of cardiac output along with each beat of the heart without the need for thermodilution.
A61B 5/028 - Mesure du débit sanguin utilisant des marqueurs, p.ex. dilution de colorant par thermodilution
A61B 5/029 - Mesure du débit de sang à la sortie du cœur, p.ex. volume éjecté par minute
A61B 5/1459 - Mesure des caractéristiques du sang in vivo, p.ex. de la concentration des gaz dans le sang, de la valeur du pH du sang en utilisant des capteurs optiques, p.ex. des oxymètres à photométrie spectrale invasifs, p.ex. introduits dans le corps par un cathéter
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
47.
SYSTEMS AND METHODS FOR DETERMINING FLOW AND CARDIAC OUTPUT
A system for determining a hemodynamic condition of a patient includes a first hemodynamic sensor and a display. The first hemodynamic sensor produces a first hemodynamic sensor signal representative of a right ventricular pressure waveform of the patient. The system further includes one or more processors and computer-readable memory encoded with instructions that, when executed by the one or more processors, cause the system to receive the first hemodynamic sensor signal, convert the right ventricular pressure waveform into an estimate of a waveform of blood flow, and extract features from the right ventricular pressure waveform. The instructions further cause the system to estimate a cardiac output of the patient based on the right ventricular pressure waveform or the features extracted from the right ventricular pressure waveform and output the waveform of blood flow and the cardiac output to the display.
A support can be configured to stabilize a delivery apparatus comprising three independently actuatable shafts extending in an axial direction. The support can comprise a track extending in the axial direction, a first cart coupled to the track and configured to couple to a first shaft, and a second cart coupled to the track and configured to couple to a second shaft. A rack can be fixedly coupled to the first cart and coupled to the second cart. The second cart can comprise a locking assembly actuatable between a first mode and a second mode. In the first mode, the second cart is slidingly coupled to the track and is fixedly coupled to the rack. In the second mode, the second cart is fixedly coupled to the track and is slidingly coupled to the rack.
A medical therapy system can comprise an electrical stimulation device comprising a plurality of electrodes configured to electrically stimulate a splanchnic nerve, a sensor device configured to provide a sensor measurement indicative of a heart preload, and a controller configured to, in response to the sensor measurement, generate a control signal configured to cause the electrical stimulation device to deliver an electric stimulation signal to the splanchnic nerve.
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
An implantable device may include a support frame and a coiled wire forming a coil stack, wherein the coiled wire has a first end and a second end, and is adapted to flex between a collapsed configuration and an extended configuration, and wherein the first end is coupled to or formed from the support frame and the second end is extendable and collapsible relative to the support frame. An implantable device may include a jacket surrounding at least a portion of the coiled wire. An implantable device may include a plurality of coiled wires forming a coil stack. An implantable device may include a coilable flow occlusion strip adapted to flex between a collapsed configuration and an extended configuration, and wherein the first end is coupled to the support frame and the second end is extendable and collapsible relative to the support frame.
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
A flow restrictor for a blood vessel can include a frame positionable within a blood vessel, an inner cell, a leaflet, and a lumen through the flow restrictor. The lumen is defined at least in part by the leaflet. An inflow edge of the leaflet can be coupled to a movable junction of the inner cell, and an outflow edge of the leaflet can be coupled to an anchoring junction of the inner cell. The movable junction of the inner cell and the inflow edge of the leaflet can be configured to move axially in response to a first increase in a blood pressure within the blood vessel, and in response to the blood pressure within the blood vessel being within a first blood pressure range. The movable junction and the leaflet can be configured such that the lumen changes size when the movable junction moves.
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
A finger cuff for optically measuring blood pressure includes a band having a closed elliptical shape, a light source within the band, and a light detector within the band. The band has a first diameter and a second diameter. The band is deformable such that the band's circumference along an interior surface is constant while the first and second diameters are variable. The light source is situated such that the light source is configured to emit light towards an interior opening of the band. The light detector is situated at a fixed non-zero angle relative to the light source with respect to a central point of the interior opening of the band such that the light detector is configured to receive the light emitted by the light source.
A61B 5/022 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres
A61B 5/0225 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres la pression étant commandée par des signaux électriques, p.ex. dérivés des bruits de Korotkoff
The present disclosure relates to a helical nosecone that can be used to dilate a puncture formed in a target tissue, and assemblies that can include the helical nosecone and a perforating member that can be used to form the pre-dilated puncture. In an example, a helical nosecone comprises a helical slot spiraling around a tapering portion of the helical nosecone, wherein the helical slot defines a plurality of helical turns. The helical nosecone can be advanced in a screw-like motion through a puncture formed in a target tissue, such as a host leaflet of an existing valvular structure, so as to expand the puncture and form an opening.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
54.
SYSTEMS AND DEVICES HAVING MULTIFUNCTIONAL CONNECTORS FOR HYBRID APPLICATIONS AND PRESSURE MONITORING
The disclosure generally describes hybrid connectors for medical devices. Such connectors can include multiple connection types to facilitate communication of a distal medical tool with a monitoring system or power source in which multiple types of communication is needed. Such communication can be electrical, electronic, fluid, light, and/or any other energy or matter to be utilized by a medical tool. Connectors for hemodynamic monitoring devices can utilize a connector comprising fluid and electrical communication to connect with a blood pressure cuff and other hemodynamic sensors.
H01R 13/00 - CONNEXIONS CONDUCTRICES DE L'ÉLECTRICITÉ; ASSOCIATION STRUCTURELLE DE PLUSIEURS ÉLÉMENTS DE CONNEXION ÉLECTRIQUE ISOLÉS LES UNS DES AUTRES; DISPOSITIFS DE COUPLAGE; COLLECTEURS DE COURANT - Détails de dispositifs de couplage des types couverts par les groupes ou
H01R 31/06 - Pièces intermédiaires pour joindre deux pièces de couplage, p.ex. adaptateur
55.
STABILIZER CLAMP APPARATUS FOR USE WITH IMPLANT DELIVERY APPARATUS
Devices, systems, and methods for stabilizing delivery apparatus and/or guide catheter apparatus during delivery and implantation of a prosthetic implant are disclosed. Each of the delivery and guide catheter apparatus can include a handle and a shaft (delivery shaft or guide catheter shaft) extending distally from the handle. A distal cap portion of each of the handles can be coupled to a stabilizer clamp of a stabilizer system to retain a position of the handles relative to each other in an axial direction. The stabilizer clamps are configured to enable rotation of the distal cap therein so that torque applied to a handle is transmitted to a respective shaft. A jaw portion of the stabilizer clamp can be configured to balance or equalize toque resistance for rotation of the handle in a first (for example, clockwise) direction relative to a second opposing (for example, counterclockwise) direction.
A stent implant includes a first stent segment having a non-circular axial cross-sectional shape in a relaxed configuration thereof, second and third stent segments on opposite sides of the first stent segment, the second and third stent segments having a circular relaxed axial cross- sectional shape, a fluid-tight covering disposed on at least one of an outer diameter or an inner diameter of the first, second, and third stent segments, and a blood flow egress channel in fluid communication with a space on the outer diameter of the first stent segment, the blood flow egress channel configured to permit blood flow to pass axially out of the space through the blood flow egress channel.
A61F 2/915 - Stents ayant une forme caractérisée par des éléments filiformes; Stents ayant une forme caractérisée par une structure de type filet ou de type à mailles caractérisés par une structure de type filet ou de type à mailles fabriquée à partir de feuilles perforées ou de tubes perforés, p.ex. perforés par découpe au laser ou gravés avec des bandes présentant une structure en méandre, des bandes adjacentes étant reliées l’une à l’autre
57.
SYSTEM AND METHOD FOR ULTRASONIC WELD CONDUCTOR ALIGNMENT
A wire housing assembly includes a housing and a wire. The housing includes a first swaging groove and a second swaging groove. A wire is excised such that a plurality of signal conductors are exposed, and rest within the first swaging groove and the second swaging groove. A wire jacket extends from a signal conductor to a first excise point. An additional portion of the wire jacket extends from a second excise point to the end of the housing. A cavity in the housing contains the additional portion of the wire jacket. The signal conductors are anchored in between the first excise point and the second excise point. The signal conductors are swaged into place by melting the first swaging groove and the second swaging groove via an ultrasonic welder. A sensor may then contact the signal conductors.
G01L 13/00 - Dispositifs ou appareils pour la mesure des différences entre plusieurs valeurs de la pression des fluides
H01R 13/58 - Moyens pour atténuer l'effort de tension sur le câble de connexion, p.ex. serre-câble
H01R 43/02 - Appareils ou procédés spécialement adaptés à la fabrication, l'assemblage, l'entretien ou la réparation de connecteurs de lignes ou de collecteurs de courant ou pour relier les conducteurs électriques pour connexions soudées
H01R 43/28 - Appareils ou procédés spécialement adaptés à la fabrication, l'assemblage, l'entretien ou la réparation de connecteurs de lignes ou de collecteurs de courant ou pour relier les conducteurs électriques pour traiter le fil avant sa connexion aux pièces de contact, non prévus dans les groupes
H02G 3/00 - Installations de câbles ou de lignes électriques ou de leurs tubes de protection dans ou sur des immeubles, des structures équivalentes ou des véhicules
The present disclosure relates to tissue perforation assemblies that can be used for perforation and hole dilation through a tissue, such as forming an opening in a host leaflet of a host valvular structure, in which a prosthetic valve can be implanted. In an example, the tissue perforation assembly comprises a delivery nosecone (252) and a dilator (268) distal to the delivery nosecone. Each of the delivery nosecone and the dilator can have a tapering distal portion. A perforating guidewire (286) extends distally from the dilator, and a delivery guidewire extends proximally from the dilator, through a channel of the delivery nosecone. The tissue perforation assembly can be advanced towards the host valvular structure and optionally form a pilot puncture through the host leaflet by the perforating guidewire, after which the dilator can be passed through the puncture to further expand the opening.
A61B 17/22 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
59.
TISSUE CUTTING ASSEMBLIES WITH AXIALLY MOVABLE BLADES
The present disclosure relates to tissue cutting assemblies that can be used for cutting through a tissue. In an example, the tissue cutting assembly comprises a nosecone assembly and a cutting member extending therethrough. The nosecone assembly comprises a rigid member with a slot, and a flexible member positioned distally to, and attached to, the rigid member. The cutting member comprises a tubular body axially movable within a channel of the nosecone assembly, and a blade radially extending from the tubular body, configured to axially move between a concealed position, in which the blade is entirely concealed inside the slot, and an exposed position, in which a sharp edge of the blade is exposed from the nosecone assembly and can be further advanced to cut through the target tissue.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Devices and methods for providing a hemostatic valve fluid seal within a guide catheter are disclosed. A delivery apparatus can include a handle including a proximal segment including one or more fluid seals mounted within the proximal segment, an intermediate segment disposed adjacent and distal to the proximal segment, the intermediate segment including an inner surface defining a first lumen having a first inner diameter, and a distal segment disposed adjacent and distal to the intermediate segment, a shaft extending distally from the handle, the shaft including a second lumen extending between a distal end and a proximal end of the shaft, the second lumen including a second inner diameter that is smaller than the first inner diameter of the first lumen, and a fluid seal that is a circular elastomeric silicone comprising two perpendicular cross-hair cuts at the center of the seal and extending partially through the seal.
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments
Systems and methods for non-invasive blood monitoring devices are described. Electroactive materials and/or mechanical actuators can be used for non-invasive blood monitoring systems and measure blood pressure.
A61B 5/022 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par application d'une pression pour fermer les vaisseaux sanguins, p.ex. contre la peau; Ophtalmodynamomètres
Devices and methods for delivery devices for docking devices are disclosed. As an example, a delivery apparatus can include a housing, a linear actuator coupled to the housing, the linear actuator comprising a traveler and an articulation member coupled to the traveler, wherein the traveler translates axially relative to the housing based on rotation of the articulation member relative to the housing, a first shaft extending through the housing and configured to translate axially relative to the housing, a second shaft extending through the first shaft and coupled to the traveler of the linear actuator such that the second shaft and the traveler translate axially together, and a locking mechanism coupled to the housing, wherein the first shaft is prevented from moving relative to the housing in a locked configuration, and wherein the first shaft is moveable relative to the housing in an unlocked configuration.
Expandable docking stations for docking an expandable medical device can include a seat, one or more sealing portions, and/or one or more retaining portions. The seat can be unexpandable or substantially unexpandable beyond a deployed size. The one or more sealing portions can be connected to the seat and extend radially outward of the seat. The one or more sealing portions can be constructed to expand outward of the valve seat and provide a seal over a range of sizes. The one or more retaining portions can be connected to the one or more sealing portions and configured to retain the docking station at a deployed position.
A bendable catheter body 2200 having a plurality of links 2206 connected in series along a longitudinal axis. The plurality of links includes a first link having an annular first intermediate portion 2212, a first male protrusion 2218 extending proximally from the intermediate portion, and a second male protrusion extending distally from the intermediate portion. The first male protrusion is configured to be received within a first female recess 2222 of a second link of the plurality of links and includes a first pair of engagement surfaces 2228 facing the intermediate portion and first end surface. The engagement surfaces are configured to engage a pair of second engagement surfaces of the second link to limit axial extension of the catheter shaft. The first end surface is configured to engage an edge surface of a second intermediate portion of the second link to limit axial compression of the catheter body.
A prosthetic heart valve can comprise a frame and an outer sealing member disposed around an outer surface of the frame. The frame can comprise a plurality of rows of angled struts arranged to form a plurality of rows of cells defining openings in the frame, wherein the frame can be radially expandable and compressible between a radially expanded state and a radially compressed state. The outer sealing member can comprise a base portion extending around the outer surface of the frame and covering the openings of at least one of the rows of cells. The outer sealing member can further comprise at least one angled portion coupled to the base portion at an inflow end portion thereof and extending radially away from the base portion in a direction from the inflow end to an outflow end portion of the angled portion.
The present disclosure relates to a prosthetic valves that include an apex coverings attached to apices of their frames, configured to form atraumatic contact surfaces around the apices. In an example, an apex covering includes an opening through which the apex can be inserted into an inner pocket of the apex covering. The apex covering can define an outer surface that can be curved and relatively smooth. The apex covering can include a pair of flexible arms that can rest over angled struts extending from the apex, so as to increase contact area between the apex and the apex covering. Sutures can be optionally used to couples the apex covering to the frame, forming loops around the frame and grooves formed along the outer surface of the apex covering.
A docking station frame for a medical device includes a plurality of stmt portions extending from a proximal end to a distal end and forming a plurality of cells.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
68.
DELIVERY APPARATUS AND METHODS FOR IMPLANTING PROSTHETIC DEVICES
A shaft assembly to facilitate delivery of an implant to an implantation location within a patient's anatomy may comprise an outer shaft that is movable between an extended position to encapsulate the implant loaded onto a delivery apparatus and a retracted position to expose the implant for deployment at the implantation location at a distal end of the outer shaft. The outer shaft may be movable from the retracted position to the extended position to encapsulate the implant at least partially within the distal end of the outer shaft, the outer shaft comprising one or more flaring openings at the distal end of the outer shaft.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A61F 2/97 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure la gaine extérieure pouvant être fendue
A perforation device constituted of a guidewire extending from a proximal portion to a distal portion thereof, wherein the distal portion of the guidewire comprises a first section, the first section comprising an electrically conductive surface, and wherein the distal portion of the guide wire comprises a non- straight shape in a free state thereof.
A prosthetic valve includes a frame and a leaflet assembly having a plurality of leaflets coupled to the frame. The leaflet assembly is movable between an open state and a closed state to allow unidirectional blood flow through the prosthetic valve. Each leaflet includes an outflow edge, a cusp edge, and a pair of commissure tabs extending from opposite sides of the leaflet and between the outflow edge and the cusp edge. Each commissure tab is paired with an adjacent commissure tab of an adjacent leaflet to form a commissure of the leaflet assembly. The outflow edge of each leaflet includes a coaptation edge region and cut-out regions between opposite ends of the coaptation edge region and the commissure tabs. When the leaflet assembly moves between the open and closed states, the coaptation edge regions pivot relative to the commissure tabs at respective pivot axes intersecting the cut-out regions.
The present disclosure relates to tissue cutting tools that can be used for forming an opening in a target tissue, such as a host leaflet within which a guest prosthetic valve can be expanded. In an example, the tissue cutting tool comprises an actuation tube and a blade support tube extending therethrough. A distal portion of the blade support tube can be coupled to a distal portion of the actuation tube, and a proximal portion of the blade support tube can be axially movable with respect to a proximal portion of the actuation tube. The blade support tube also includes a bendable section extending between its distal and proximal portions, and configured to transition between unbent and bent configuration thereof. At least one blade is coupled to at least one arm of the bendable section.
The present disclosure relates to that can be used for forming an opening in a target tissue, such as a host leaflet within which a guest prosthetic valve can be expanded. In an example, a perforation assembly includes a delivery apparatus and an electrode, wherein a distal portion of the electrode, comprising a non-straight shape in a free state thereof, is configured to extend distally from the delivery apparatus.
A61B 17/22 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Various implementations include a sheath system and corresponding expandable introducer. The system (10) includes an elongated introducer body (310) and an elongated core member (350) received within the central lumen (312) of the introducer body. A portion of the introducer body expands in response to the outwardly directed radial force exerted on the central lumen of introducer body by the core member as it moves between the unexpanded and expanded positions.
The present disclosure relates to delivery assemblies for implantation of a prosthetic valve within a valvular structure in which an opening was formed in a host leaflet. In an example, the delivery assembly comprises a guest prosthetic valve and a delivery apparatus that includes an outer balloon, and an inner balloon axially movable relative to the outer balloon. The delivery apparatus can be advanced towards the host leaflet structure with the inner balloon kept in a concealed position. The inner balloon can then be advanced relative to the outer balloon, so as to be positioned inside the host leaflet, and inflated to form a leaflet opening within the host leaflet. The inner balloon can then be deflated and the outer balloon can be advanced into the leaflet opening, and inflated with the guest prosthetic valve disposed thereover, so as to expand the guest prosthetic valve inside the leaflet opening.
Crosslinked polyurethanes and medical devices including components made of such crosslinked polyurethanes, are disclosed. The crosslinked polyurethanes may be obtained by crosslinking a polyurethane having the formula: wherein a is from 1-10,000; b is from 1-10,000; c is from 0-500; Rcap is a capping group; [soft] represents a macrodiol segment comprising a poly(isobutylene) component; [DI] represents a diisocyante component; [CE] represents a chain extender component; [CC] represents a chain connector component, wherein one or more of [soft], [DI], [CE], and [CC] comprises a crosslinkable group. Also disclosed are methods of making the same and devices comprising the same.
C08G 18/62 - Polymères de composés contenant des liaisons doubles carbone-carbone
A61F 2/00 - Filtres implantables dans les vaisseaux sanguins; Prothèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corps; Appareils pour les assujettir au corps; Dispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p.ex. stents
C08G 18/72 - Polyisocyanates ou polyisothiocyanates
Devices and methods for equalizing pressure in a main lumen of a guide sheath shaft are disclosed. As one example, a delivery apparatus can include a handle and a shaft extending within and distally from the handle. The shaft has a main lumen, and a distal end portion of the shaft includes one or more holes that extend through a wall of the shaft, between the main lumen and an exterior of the shaft. The one or more holes are spaced axially away from a distal end of the shaft.
Devices and methods for seals are disclosed. As an example, a delivery apparatus comprises a sleeve shaft comprising a first segment and a second segment, wherein the second segment comprises an inwardly-facing outer surface and an outwardly-facing outer surface, wherein the second segment comprises a lubricious coating; and a seal coupled to the second segment of the sleeve shaft.
A physiological sensor assembly is provided that includes at least one electrode having a sensing surface and a body. The body has a plurality of exterior surfaces, including a contact surface, at least one pocket disposed in the contact surface, at least one gel vent in fluid communication with the at least one pocket, and at least one vent passage configured to provide fluid communication between the at least one gel vent and at least one exterior surface. The at least one pocket is open to the contact surface. The at least one electrode is disposed in the at least one pocket.
A61B 5/291 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci Électrodes bioélectriques à cet effet spécialement adaptées à des utilisations particulières pour l’électroencéphalographie [EEG]
A61B 5/00 - Mesure servant à établir un diagnostic ; Identification des individus
A cardiac implant comprises a first fluid transfer device configured for placement at least partially within a blood vessel of a heart, a second fluid transfer device configured for placement outside the blood vessel, and one or more lines interconnecting the first fluid transfer device and the second fluid transfer device.
A61M 60/17 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables dans ou sur le cœur, ou autour du cœur à l’intérieur d’un ventricule, p.ex. pompes à ballon intra-ventriculaires
A method of assisting cardiac performance involves accessing a thoracic cavity near a heart with an access tube, delivering, via the access tube, an expandable implant in a compressed form into the thoracic cavity, and expanding the expandable implant to cause compression of the heart.
A61M 60/191 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables dans ou sur le cœur, ou autour du cœur agissant mécaniquement sur l’extérieur du cœur natif du patient, p.ex. structures compressives placées autour du cœur
A61M 60/465 - Pompes pour le sang; Dispositifs pour l'actionnement mécanique de la circulation; Pompes à ballon d’assistance circulatoire - Détails concernant l’entraînement pour des dispositifs d’actionnement circulatoire mécanique
A method of managing blood flow involves providing a vascular implant device comprising a compliant tube, advancing the vascular implant device to a target location within a target blood vessel through a transcatheter access path, anchoring first and second end portions of the vascular implant device to the target blood vessel, at least a portion of the compliant tube being disposed between the first and second end portions, and resecting a portion of the target blood vessel around the at least a portion of the compliant tube.
A61F 2/848 - Dispositifs maintenant le passage ou évitant l’affaissement de structures tubulaires du corps, p.ex. stents avec des moyens de fixation à la paroi du vaisseau, p.ex. des barbes
A61F 2/89 - Stents ayant une forme caractérisée par des éléments filiformes; Stents ayant une forme caractérisée par une structure de type filet ou de type à mailles les éléments filiformes comprenant au moins deux anneaux adjacents reliés de manière flexible par des éléments séparés
A delivery apparatus can comprise a shaft comprising a proximal end portion coupled to a handle, a distal end portion configured to couple to a prosthetic medical device, and a central longitudinal axis extending therebetween. The delivery apparatus can further comprise a rotation gauge configured to provide a real-time indication of a rotational movement of the prosthetic medical device about the central longitudinal axis based on a rotational movement of the proximal end portion of the shaft about the central longitudinal axis and a transmission ratio of the shaft. The transmission ratio can be a ratio of a rotational movement of the distal end portion of the shaft to a rotational movement of the proximal end portion of the shaft, wherein the rotational movement of the proximal end portion of the shaft results in the rotational movement of the distal end portion of the shaft.
A prosthetic valve includes a flexible frame disposed along and deformable about a frame axis. The frame includes a first end, a second end oppositely disposed from the first end, a plurality of post assemblies extending axially away from the first end, and a network of interconnected struts defining a plurality of cells. A circuit is disposed axially away from the frame and mounted on the plurality of post assemblies. The circuit includes an antenna coil secured to at least two post assemblies of the plurality of post assemblies, and a sensor in electrical communication with the antenna coil. The sensor is configured to sense a physical parameter and generate a signal representing the physical parameter.
An implantable medical device includes a wire frame, a cover, and a sensor. The wire frame is formed of struts and openings. The cover connects to the struts of the wire frame. The cover is fashioned from a fabric including a PET fabric made of PET yarn and a ferromagnetic material combined with the PET fabric. The PET yarn is made from a plurality of PET fibers. The sensor is positioned on the cover and connected to the wire frame. The cover shields the sensor from detuning effects of the wire frame.
Systems and methods are described for modulating blood flow through a blood vessel. The systems may include one or more implantable devices including a stent frame positionable within the blood vessel, the stent frame having a substantially oval cross-sectional shape, and a valve defining an inflow end and an outflow end. The inflow end may be coupled to the stent frame and the outflow end defining an aperture and the valve may include at least one leaflet at the outflow end. The at least one leaflet may be positionable to overlay at least a portion of the aperture and configured to move in a radial direction that is perpendicular to a central axis of the stent frame.
A61F 2/82 - Dispositifs maintenant le passage ou évitant l’affaissement de structures tubulaires du corps, p.ex. stents
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
A modular stent includes a first oval stent segment, a second oval stent segment, and a linking arm coupled to a major-axis side of the first oval stent segment and to a major-axis side of the second oval stent segment.
A61F 2/915 - Stents ayant une forme caractérisée par des éléments filiformes; Stents ayant une forme caractérisée par une structure de type filet ou de type à mailles caractérisés par une structure de type filet ou de type à mailles fabriquée à partir de feuilles perforées ou de tubes perforés, p.ex. perforés par découpe au laser ou gravés avec des bandes présentant une structure en méandre, des bandes adjacentes étant reliées l’une à l’autre
An intravascular spring implant device includes first and second tissue-contact end portions configured to press against an inner diameter of a target blood vessel and one or more spring elements configured to be compressed in a manner as to reduce a distance between the first and second tissue-contact end portions.
A medical implant assembly can include a longitudinally expandable member comprising an elongate portion configured to be reversibly expandable along a longitudinal dimension. The longitudinally expandable member can be configured to be secured to a ventricular heart wall surface oriented toward a heart ventricle, expanded to an expanded state as the heart ventricle expands during diastole, and compressed to a compressed state as the heart ventricle contracts during systole. A first anchor can be configured to be coupled to a first portion of the longitudinally expandable member to secure the first portion of the longitudinally expandable member to a first location on the ventricular heart wall surface. A second anchor can be configured to be coupled to a second portion of the longitudinally expandable member to secure the second portion of the longitudinally expandable member to a second location on the ventricular heart wall surface.
Devices, systems, and/or methods can treat aneurysms and/or other conditions, while providing compliance characteristics to fluid vessels. Examples of the present disclosure can include an implant device with one or more sealing/tube features configured to attach to a fluid vessel and a compliant structure coupled to the one or more sealing/tube features. The compliant structure can include a frame and/or covering configured to expand and contract radially based on pressure within the fluid vessel to provide a change in volume.
A septal occluder includes a structural framework and a flexible skin supported by the structural framework. The structural framework includes a cylindrical section interposed between end sections. Each of the cylindrical section and end sections include interconnected struts that form a mesh. The cylindrical section extends along a centerline axis to define a bore. The flexible skin includes a membrane gate, a mechanical gate, or a membrane gate and mechanical gate spanning the bore.
Devices, systems, and/or methods can treat aneurysms and/or other conditions, while providing compliance characteristics to fluid vessels. Examples of the present disclosure can include an implant device that includes a tubular structure with multiple first sections that deflect radially inward and that are separated by multiple second sections. The second sections can include lobes. The first sections can be configured to deflect radially outward based on radial/luminal pressure within a fluid vessel to provide a change in volume for the implant device.
A61F 2/90 - Stents ayant une forme caractérisée par des éléments filiformes; Stents ayant une forme caractérisée par une structure de type filet ou de type à mailles caractérisés par une structure de type filet ou de type à mailles
A non-circular stent includes a stent frame including a first stent frame segment having a non-circular axial cross-sectional shape in a relaxed configuration thereof, the first stent frame segment including first and second minor-axis wall portions and first and second major-axis wall portions and a plurality of tissue-engagement projections emanating from the first and second minor-axis wall portions and configured to couple the first and second minor-axis wall portions to a blood vessel wall. Some examples of non-circular stents assemblies include a stent frame including a first stent frame segment having a non-circular axial cross-sectional shape in a relaxed configuration thereof, the first stent frame segment including first and second minor-axis wall portions and first and second major-axis wall portions, and a plurality of tissue anchors projecting radially outward from the first stent frame segment, the plurality of tissue anchors being secured to the first stent frame segment.
A61F 2/848 - Dispositifs maintenant le passage ou évitant l’affaissement de structures tubulaires du corps, p.ex. stents avec des moyens de fixation à la paroi du vaisseau, p.ex. des barbes
A61F 2/915 - Stents ayant une forme caractérisée par des éléments filiformes; Stents ayant une forme caractérisée par une structure de type filet ou de type à mailles caractérisés par une structure de type filet ou de type à mailles fabriquée à partir de feuilles perforées ou de tubes perforés, p.ex. perforés par découpe au laser ou gravés avec des bandes présentant une structure en méandre, des bandes adjacentes étant reliées l’une à l’autre
93.
SYSTEMS AND DEVICES FOR PERFORMING INCISIONS ON TISSUE
Systems and devices for incising tissue are provided. A system can comprise a catheter, a vacuum system, and a means for incising tissue. The vacuum system can grasp a tissue to assist the incision. The means for incision can be a blade, a wire, or other means capable of penetrating and traversing through tissue.
A61B 17/3211 - Scalpels chirurgicaux ou bistouris; Leurs accessoires
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Devices, systems, and/or methods can provide compliance characteristics to fluid vessels. For example, an implant device can include an anchoring region to anchor the implant device to a blood vessel or other anatomy. The anchoring region can be disposed at one end of a flexible midsection that is configured to expand as a result of fluid flowing through the implant device. The flexible midsection can include another anchoring region at an opposite end. One or both anchoring regions are configured to encourage tissue ingrowth at an outer surface of the respective anchoring region.
Example implant delivery systems include an elongate sheath having an oval cross-sectional shape, and a tapered nose cone configured to engage a distal end of the elongate shaft, the nose cone having a base portion with an oval shape. Some example implant delivery systems include an elongate sheath and a collapsible nose cone configured to be configured in a first configuration having a first maximum diameter and a second configuration having a second maximum diameter less than the first maximum diameter. Some example implant delivery systems include an elongate sheath having a first diameter and a nose cone having a second diameter less than the first diameter, and a flexible cover configured to cover a distal opening of the elongate sheath between a distal end of the elongate sheath and the nose cone, the cover having an opening configured to assume an expanded configuration and a contracted configuration.
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p.ex. utilisant une tige poussoir
A packaging for a medical device heavy monitor includes a molded pulp top half and a molded pulp bottom half. The molded pulp top half includes a top body portion, a first top flap connected to a first end of the top body portion, and a second top flap connected to a second end of the top body portion. The top half is shaped to fit around a top of the medical device heavy monitor. The molded pulp bottom half includes a bottom body portion, a first bottom flap connected to a first end of the bottom body portion, and a second bottom flap connected to a second end of the bottom body portion. The bottom half is shaped to fit around a bottom of the medical device heavy monitor.
B65D 5/50 - Parties insérées dans le réceptacle, qui en font partie intégrante ou qui lui sont fixées pour former des garnitures intérieures ou extérieures Éléments internes de support ou de protection du contenu
B65D 81/05 - Réceptacles, éléments d'emballage ou paquets pour contenus présentant des problèmes particuliers de stockage ou de transport ou adaptés pour servir à d'autres fins que l'emballage après avoir été vidés de leur contenu spécialement adaptés pour protéger leur contenu des dommages mécaniques maintenant le contenu en position éloignée des parois de l'emballage ou des autres pièces du contenu
A delivery system can comprise a delivery apparatus and a stabilizer assembly. The delivery apparatus can comprise a delivery shaft, a sleeve shaft, a pusher shaft, a hub assembly coupled to the pusher shaft, and a sleeve handle coupled to the sleeve shaft. The delivery shaft, sleeve shaft, and pusher shaft can be independently actuatable. The stabilizer assembly can include a hub assembly cradle configured to receive the hub assembly, a sleeve handle cradle configured to receive the sleeve handle, and a linear actuator configured to move the hub assembly cradle in an axial direction relative to the sleeve handle cradle. The stabilizer assembly can be configured to actuate the hub assembly relative to the sleeve handle while keeping the sleeve handle stationary, thereby stabilizing the delivery apparatus in such a way that allows for independent actuation of the delivery shaft, the sleeve shaft, and the pusher shaft.
A cardiac device configured to be positioned in a heart includes a body configured to be positioned in a wall between a right pulmonary vein and a right atrium or a superior vena cava and a sensor attached to the cardiac device. The sensor includes a sensor housing, a transducer, and control circuitry in the sensor housing in electrical communication with the transducer that is configured to sense a signal from a fluid in the right pulmonary vein, the right atrium, or the superior vena cava or a signal from the heart.
A prosthetic heart valve comprises a radially expandable frame comprising inflow and outflow ends and a central longitudinal axis extending between the inflow and outflow ends, wherein the frame defines a partially radially compressed diameter in a partially radially compressed state and a radially expanded diameter in a radially expanded state. A sealing skirt coupled to the frame comprises inflow and outflow end portions, an inelastic skirt portion comprising weft and warp threads, and a tensioning element coupled to and extending circumferentially along the outflow end portion. When the sealing skirt is in a relaxed state, a terminal outflow edge defines a skirt diameter that is greater than or equal to the partially radially compressed diameter and less than the radially expanded diameter and the pluralities of weft and warp threads are configured to be oriented at an approximately 45-degree angle to the central longitudinal axis.
Devices for handles of delivery apparatuses for prosthetic medical devices are disclosed. As one example, a handle for a delivery apparatus comprises an outer housing and a spine positioned within the outer housing. The spine comprises a central lumen, an axially extending recess that is depressed radially into the spine from an outer surface of the spine toward the central lumen, and a support wall separating the central lumen and the axially extending recess. The handle further comprises a pull wire that extends through the recess and out of a proximal end portion of the recess to a wire wrap coupled to the outer surface of the spine.
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